|Publication number||US7967178 B2|
|Application number||US 12/353,607|
|Publication date||Jun 28, 2011|
|Priority date||Oct 6, 2006|
|Also published as||CA2650352A1, CA2650352C, EP2082691A1, EP2082691B1, EP2452635A2, EP2452635A3, EP2452635B1, US8424736, US8684247, US20090145947, US20110240713, US20110272448, US20130221066|
|Publication number||12353607, 353607, US 7967178 B2, US 7967178B2, US-B2-7967178, US7967178 B2, US7967178B2|
|Inventors||Paul Scirica, John W. Beardsley|
|Original Assignee||Tyco Healthcare Group Lp|
|Export Citation||BiBTeX, EndNote, RefMan|
|Patent Citations (87), Non-Patent Citations (2), Referenced by (51), Classifications (10), Legal Events (3)|
|External Links: USPTO, USPTO Assignment, Espacenet|
The present application claims the benefit of priority to U.S. Provisional Application Ser. No. 61/062,389 filed on Jan. 25, 2008, and is also a continuation-in-part of U.S. patent application Ser. No. 12/200,057 filed Aug. 28, 2008, which is a continuation-in-part of U.S. application Ser. No. 11/544,061 filed on Oct. 6, 2006, all of which are incorporated herein in its entirety by reference.
1. Technical Field
The present disclosure relates to a surgical stapling device and, more particularly, to an endoscopic surgical stapling device configured to operate a tool assembly in a grasping mode independent of a clamping and/or firing mode.
2. Background of Related Art
Surgical devices wherein tissue is first grasped or clamped between opposing jaw structure and then joined by surgical fasteners are well known in the art. The fasteners are typically in the form of surgical staples, but two-part polymeric fasteners can also be utilized.
Instruments for this purpose can include a tool assembly with two elongated members which are respectively used to capture or clamp tissue. Typically, one of the members carries a staple cartridge which houses a plurality of staples arranged, for example, in at least two lateral rows while the other member has an anvil that defines a surface for forming the staple legs as the staples are driven from the staple cartridge. In some staplers, the stapling operation is effected by cam bars that travel longitudinally through the staple cartridge, with the cam bars acting upon staple pushers for sequentially ejecting the staples from the staple cartridge. A knife can travel between the staple rows for longitudinally cutting the stapled tissue between the rows of staples. Such staplers are disclosed in U.S. Pat. Nos. 6,250,532 and 6,241,139, each of which are currently owned by Tyco Healthcare Group LP, and are incorporated herein by reference in their entirety.
In endoscopic or laparoscopic procedures, surgery is performed through small incisions or through small diameter cannulas inserted through small entrance wounds in the skin. Due to the limited degree of motion of an instrument when it is positioned through the skin, it may be quite difficult for a surgeon to manipulate the tool assembly of the instrument around body tissue to access and/or clamp the tissue site. Instruments having rotatable endoscopic body portions and rotatable and/or articulatable tool assemblies have been developed to overcome this problem and are commercially available. Although these instruments provide significant improvements in the endoscopic tool art, further improvements that may decrease the time required for surgical procedures and allow easier access to tissue sites are desired.
Accordingly, a continuing need exists for an endoscopic or laparoscopic surgical device having a tool assembly which can be quickly and easily manipulated between different modes of operation.
In accordance with the present disclosure, a surgical stapling device is provided which includes a handle assembly having a movable handle, an elongated member, and a disposable loading unit (“DLU”). The DLU includes a tool assembly positioned at a distal end having an anvil assembly and a cartridge assembly. The elongated member is rotatably secured to the handle assembly. The tool assembly is a stapling device and the handle assembly includes a grasping pawl which is movable into engagement with an actuation shaft or actuation member to allow the tool assembly to be operated in a grasper mode. More specifically, the grasping pawl is manipulated by a pair of slide buttons slidably positioned on opposed sides of the handle assembly and is selectively movable into engagement with the actuation shaft to allow the actuation shaft to move a distance which will, upon operation of the movable handle, effect approximation of cartridge and anvil assemblies of the tool assembly, but will not affect the firing of staples.
In another aspect of the disclosure, a rotation control member is rotatably mounted to the forward end of the handle assembly to facilitate rotation of elongated member with respect to the handle assembly.
In another aspect of the present disclosure, a surgical device comprises an end effector; an endoscopic shaft defining a longitudinal axis; and a handle assembly. The handle assembly comprises a longitudinally movable actuation member and a pivotable handle having an engagement member movably mounted with respect to the pivotable handle and arranged to pivot with the pivotable handle. The device also includes a depressible button arranged to engage the engagement member and move the engagement member between a first position in which the engagement member moves the actuation member longitudinally and a second position in which the engagement member does not move the actuation member.
The engagement member, in certain embodiments, has an arm slidably mounted on the pivotable handle and a pawl pivotably mounted with respect to the arm. The actuation member has a plurality of teeth and the pawl slides over the teeth when the engagement member is in the second position. The pawl engages the teeth when the engagement member is in the first position.
The handle assembly may have an advancement pawl movable with the pivotable handle and biased into engagement with the actuation member. The advancement pawl is arranged to engage teeth of the actuation member and move the actuation member longitudinally when the engagement member is in the second position.
The surgical device in certain embodiments has a locking member biased into engagement with the actuation member, to prevent longitudinal movement of the actuation member. A disconnect assembly having an angled stepped portion is arranged to engage the locking member and move the locking member away from the actuation member. The disconnect assembly includes a first link, having the angled stepped portion, and a second link pivotably attached to the first link at a first end and pivotably attached to the pivotable handle at a second end of the second link. The first link and the second link are dimensioned so that the angled stepped portion does not engage the locking member when the engagement member is in the first position.
In yet another aspect of the disclosure, an articulation lever is mounted adjacent the rotation control member to facilitate articulation of the tool assembly.
Embodiments of the presently disclosed surgical stapling device are disclosed herein with reference to the drawings wherein:
Embodiments of the presently disclosed grasping jaw mechanism will now be described in detail with reference to the drawings in which like reference numerals designate identical or corresponding element in each of the several views.
Throughout this description, the term “proximal” will refer to the portion of the device closest to the operator and the term “distal” will refer to the portion of the device furthest from the operator.
Handle assembly 13 includes a stationary handle 18, a movable handle 20, and a barrel portion 19. A rotation control member 22 is rotatably mounted at the forward end of barrel portion 19 to facilitate rotation of elongated member 14 with respect to handle assembly 13. Rotation control member 22 is formed from molded plastic half-sections 12 a and 12 b, although other materials, e.g., metals, and manufacturing methods are envisioned. An articulation lever 24 is also mounted on the forward end of barrel portion 19 adjacent rotation control member 22 to facilitate articulation of tool assembly 27. U.S. Patent No. 5,865,361 to Milliman et al., which is owned by Tyco Healthcare, LP, describes a rotation control assembly and articulation assembly for a surgical stapling apparatus and is hereby incorporated herein by reference in its entirety.
A pair of retractor knobs 15 is movably positioned along barrel portion 19 to return device 10 to a retracted position, as will be described in detail below (see
Handle assembly 13 includes a housing 12 formed from a pair of molded half-sections 12 a and 12 b, which forms stationary handle 18 and barrel portion 19 of handle assembly 13. Half-sections 12 a and 12 b are formed of a thermoplastic material, e.g., polycarbonate. Alternately, other materials having the requisite strength requirements may be used to form housing 12, e.g., surgical grade metals. Housing 12 half-sections 12 a and 12 b are secured to each other using known fastening techniques, e.g., adhesives, welding, interlocking structure, screws, etc. Alternately, other fastening techniques may be used.
Actuation member or actuation shaft 90 is slidably supported between retracted and advanced positions within barrel portion 19 of housing 12 and includes a distal end defining a recess 94 configured to rotatably receive the proximal end 97 of a control rod 95. Actuation shaft 90 includes a toothed rack 92. Advancement pawl 35 has an engagement finger 35 a which is biased by spring 36 towards toothed rack 92 of actuation shaft 90. When movable handle 20 is actuated, i.e., is pivoted towards stationary handle 18 against the bias of a torsion spring (not shown), engagement finger 35 a of pawl 35 engages toothed rack 92 of actuation shaft 90 to advance actuation shaft 90 and control rod 95 distally.
Referring to FIGS. 3 and 5-8, a vertical pawl 120 is a pawl, plate, or other engagement member or locking member slidably positioned in a slot 121 (see
A plunger 30 is reciprocably supported between spaced cylindrical channels (not shown) formed in housing half-sections 12 a and 12 b. Plunger 30 includes a cam member 32. A spring (not shown) may be positioned on each end of plunger 30 within spaced cylindrical channels (not shown) to urge plunger 30 to a position wherein cam member 32 is centrally positioned between a pair of cam surfaces 122 formed on vertical pawl 120 (see
Each end 30 a of plunger 30 extends through stationary handle 18 and can be pressed against the bias of a spring (not shown) to force cam member 32 into engagement with a respective one of cam surfaces 122 on vertical pawl 120. When cam member 32 is moved into engagement with one of cam surfaces 122, vertical pawl 120 is urged from the extended position to the retracted position to move tip 125 of vertical pawl 120 out of cutout 93 of actuation shaft 90 (see
Outturned portion 52 of pawl arm 50 includes a recessed groove 53 having a pair of throughbores 57 dimensioned to slidably receive a pivot pin 56. A biasing spring 64 is configured at one end for insertably receiving a pivot pin 62 therein and is insertably received within recessed groove 53 at the other end. Grasping pawl 60 includes a pair of lateral extensions 60 a and 60 b defining a recess 60 c. Pivot pin 56 is received by an opening 61 in a bottom end of grasping pawl 60. Pivot pin 62 is pivotally received within recess 60 c such that grasping pawl 60 is pivotal in a proximal direction about pivot pin 62 in relation to pawl arm 50. Recessed groove 53 is dimensioned to accommodate the pivoted motion of grasping pawl 60 between a straight position, i.e., along the longitudinal axis of pawl arm 50, and a proximal or rearward position. Lateral extension 60 a is configured to contact a surface 53 a of recessed groove 53, such that the pivoting motion of grasping pawl 60 is restricted to a proximal direction from a straight position with respect to pawl arm 50. Lateral extension 60 b is configured to pivot through groove 53 in portion 52 to allow pivoting motion of grasping pawl 60 into the proximal or rearward position. In the proximal or rearward position, lateral extension 60 b depresses pivot pin 62, and thus spring 64, within a bore 63 defined in outturned portion 52 (see
Pawl latch 302 has a proximal end 302 a having an angled surface 302 b and a tapered distal end 302 c defining a catch member 302 d. Disconnect member 304 includes tapered or rounded distal and proximal ends 304 a and 304 b. A biasing member or spring 310 is positioned in each of recesses 306 and 308 to urge pawl latch 302 and disconnect member 304 proximally.
Adaptor block 300 is supported in handle assembly 213 such that the distal end of pawl latch 302 and disconnect member 304 are positioned adjacent vertical pawl 320. The proximal end of pawl latch 302 is positioned to engage sloped surface 255 of pawl aim 250 upon actuation of movable handle 220 when the pawl assembly 267 is in the grasper mode and pawl arm 250 is extended. When pawl assembly is retracted by moving slide buttons or switches 240 and 245 (
Grasper jaw mechanism 500 includes a disconnect link assembly 502 and an actuator assembly 504. As will be discussed in further detail below, disconnect link assembly 502 functions to prevent engagement of vertical pawl 430 with actuation shaft 490 when handle assembly 413 is in grasper mode to allow for proximal and distal movement of actuation shaft 490. Actuator assembly 504 prevents the movable handle 420 from returning fully to the non-compressed position when handle assembly 413 is in grasper mode to prevent advancement pawl 435 from engaging toothed rack 492. By doing this, operation of movable handle 420 is prevented from advancing actuation shaft 490 distally beyond the clamped position of DLU 16 (
Referring also to
Actuator button 514 is slidably positioned through a bore 526 (
In its initial or original position shown in
As illustrated in
As discussed above, actuator button 514 is supported on movable handle 420 and extends through opposite sides of housing 412 of handle assembly 413. In order to facilitate, movement of actuator button 514 with movable handle 420, arc shaped slots (not shown) are provided in housing 412. In one embodiment, raised surfaces or bosses are provided about a portion of the arc shaped slots which prevent depressing actuator button 514 until movable handle 420 has been moved to a compressed position. As discussed above, the grasping pawl 518 is pivotably supported at a distal end of pawl arm 516. In other embodiments, the assembly is dimensioned so that the actuator button 514 moves the pawl arm 516 away from the teeth of the actuation shaft. As discussed above, the surgical device is initially in the grasper mode, with the grasping pawl 518 in engagement with the actuation shaft and the actuator button 514 moves the grasping pawl 518 into a position in which the grasping pawl 518 no longer moves the actuation shaft as the movable handle 420 is pivoted. In other embodiments, the surgical device is initially in an alternate mode, with the grasping pawl 518 in a position in which the grasping pawl 518 does not move the actuation shaft as the movable handle 420 is pivoted. When the actuator button is pushed, the grasping pawl is moved into a position in which the grasping pawl 518 moves the actuation shaft as the movable handle 420 is pivoted.
In each embodiment discussed above, retractor knobs are manually grasped to retract the actuation shaft. For example, a retraction mechanism which includes retractor knobs 15 (see
In use, when retractor knobs 15 are pulled rearwardly or proximally, coupling rod 96 initially moves release plate 70 rearward in relation to actuation shaft 90 as coupling rod 96 slides in slots 98 of actuation shaft 90. As this occurs, release plate 70 is moved downwardly by pins 91 with respect to actuation shaft 90 thereby covering toothed rack 92 to disengage engaging finger 35 a of advancement pawl 35 from toothed rack 92. Once coupling rod 96 reaches a position at which it engages the proximal end of slots 98, additional rearward movement of retractor knobs 15 causes retraction of actuation shaft 90 and thus retraction of control rod 95 rearwardly. Actuation shaft 90 is biased proximally by spring 64 76 which is secured at one end to coupling rod portion 96 c via a connector 75 and at the other end to a post 77 on actuation shaft 90.
In certain embodiments discussed above, the surgical stapling device is initially in the grasping mode. For example, surgical stapling device 10 is initially in the grasping mode. Referring to
Movable handle 20 returns to its initial position and urges yoke 80 to rotate clockwise. Clockwise rotation of yoke 80 forces arm 80 b of yoke 80 to engage post 43 on slide button 45 to urge slide buttons 40 and 45 into the upward position. In the upward position, grasping pawl 60 is pivotally biased downward by slot 92 a in toothed rack 92, instead of slot 92 b, as toothed rack 92 has been advanced (see
Often in endoscopic procedures, tissue must be manipulated or pulled aside to allow surgeons to access and/or view the tissue site before clamping and stapling can be performed. Selectable modes of operation appreciated by the present disclosure allows surgeons the benefit of operating device 10 in the grasping mode wherein tool assembly 27 may be manipulated by operation of movable handle 20 to grasp and manipulate tissue before easily switching device 10 to the clamping mode of operation wherein tool assembly 27 is configured to clamp tissue and apply staples. The mechanisms discussed above may be used to change between modes, in surgical devices other than stapling devices. DLUs other than a stapling DLU may be used.
Device 10 starts out in grasping mode, per
Sliding slide buttons 40, 45 down moves grasping pawl 60 away from slot 92 b and pawl arm 50 away from cam member 100 of locking cam assembly 107. When movable handle 20 is manipulated to clamp tissue, grasping pawl 60 moves into slot 92 a such that vertical pawl 120 engages cutout 93. Plunger 30 is pushed and releases vertical pawl 120. When movable handle 20 is manipulated, advancement pawl 35 advances toothed rack 92, firing staples. Multiple strokes of movable handle 20 are used to advance toothed rack 92, with advancement pawl 35 repeatedly engaging and disengaging toothed rack 92. Yoke 80 maintains slide buttons 40, 45 in the upward position during firing. After retractor knobs 15 are used to retract toothed rack 92, grasping pawl 60 is aligned with slot 92 b and device 10 is in the grasping mode again.
In an alternative embodiment, surgical stapling device 10 may be provided with a grasping mode, but without plunger 30. In this embodiment, vertical pawl 120 and locking cam assembly 107 are removed.
Device 10 starts in grasping mode, per
Sliding slide buttons 40, 45 down moves grasping pawl 60 away from slot 92 b. When movable handle 20 is manipulated to clamp tissue, grasping pawl 60 moves into slot 92 a. As movable handle 20 is further manipulated, advancement pawl 35 advances toothed rack 92 and fires staples. Multiple strokes of movable handle 20 are used to advance toothed rack 92, with advancement pawl 35 repeatedly engaging and disengaging toothed rack 92. Yoke 80 maintains slide buttons 40, 45 in the upward position during firing. After retractor knobs 15 are used to retract toothed rack 92, grasping pawl 60 is aligned with slot 92 b and device 10 is in the grasping mode again.
It will be understood that various modifications may be made to the embodiments disclosed herein. For example, it is envisioned that the surgical stapling device disclosed may be used in association with other surgical devices, e.g., clip appliers, dissectors, electrosurgical sealing devices, etc. Further, the device may also include tool assemblies other than staplers or those devices which eject a fastener, e.g., sealing devices (electrosurgical and non-electrosurgical), etc. The button or other actuator for changing the mode of operation for the device may be provided on one side or both sides of the handle assembly. Therefore, the above description should not be construed as limiting, but merely as exemplifications of preferred embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.
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|US8899462||Oct 25, 2011||Dec 2, 2014||Covidien Lp||Apparatus for endoscopic procedures|
|US8931681||May 13, 2014||Jan 13, 2015||Covidien Lp||Surgical instrument and cartridge for use therewith|
|US8939343||Dec 31, 2013||Jan 27, 2015||Covidien Lp||Surgical stapling apparatus including a drive beam|
|US8979827||Mar 14, 2012||Mar 17, 2015||Covidien Lp||Surgical instrument with articulation mechanism|
|US9016539||Oct 25, 2011||Apr 28, 2015||Covidien Lp||Multi-use loading unit|
|US9016545||Aug 21, 2014||Apr 28, 2015||Covidien Lp||Apparatus for endoscopic procedures|
|US9027817||Dec 15, 2014||May 12, 2015||Covidien Lp||Surgical stapling apparatus including sensing mechanism|
|US9155537||Jul 11, 2012||Oct 13, 2015||Covidien Lp||Surgical fastener applying apparatus|
|US9179911||May 23, 2014||Nov 10, 2015||Ethicon Endo-Surgery, Inc.||End effector for use with a surgical fastening instrument|
|US9204878||Aug 14, 2014||Dec 8, 2015||Ethicon Endo-Surgery, Inc.||Surgical stapling apparatus with interlockable firing system|
|US9211120||Mar 28, 2012||Dec 15, 2015||Ethicon Endo-Surgery, Inc.||Tissue thickness compensator comprising a plurality of medicaments|
|US9211121||Jan 13, 2015||Dec 15, 2015||Ethicon Endo-Surgery, Inc.||Surgical stapling apparatus|
|US9216013||Feb 18, 2013||Dec 22, 2015||Covidien Lp||Apparatus for endoscopic procedures|
|US9220501||Mar 28, 2012||Dec 29, 2015||Ethicon Endo-Surgery, Inc.||Tissue thickness compensators|
|US9232944||May 2, 2013||Jan 12, 2016||Covidien Lp||Surgical instrument and bushing|
|US9241714||Mar 28, 2012||Jan 26, 2016||Ethicon Endo-Surgery, Inc.||Tissue thickness compensator and method for making the same|
|US9271728||May 16, 2012||Mar 1, 2016||Covidien Lp||Surgical fastener applying apparatus|
|US9271799||Jun 25, 2014||Mar 1, 2016||Ethicon Endo-Surgery, Llc||Robotic surgical system with removable motor housing|
|US9272406||Feb 8, 2013||Mar 1, 2016||Ethicon Endo-Surgery, Llc||Fastener cartridge comprising a cutting member for releasing a tissue thickness compensator|
|US9282962||Feb 8, 2013||Mar 15, 2016||Ethicon Endo-Surgery, Llc||Adhesive film laminate|
|US9283054||Aug 23, 2013||Mar 15, 2016||Ethicon Endo-Surgery, Llc||Interactive displays|
|US9289206||Dec 15, 2014||Mar 22, 2016||Ethicon Endo-Surgery, Llc||Lateral securement members for surgical staple cartridges|
|US9289209||May 16, 2012||Mar 22, 2016||Covidien Lp||Surgical fastener applying apparatus|
|US9289211||Jun 21, 2013||Mar 22, 2016||Covidien Lp||Surgical stapling apparatus|
|US9289212||Sep 17, 2010||Mar 22, 2016||Ethicon Endo-Surgery, Inc.||Surgical instruments and batteries for surgical instruments|
|US9295465||Nov 30, 2012||Mar 29, 2016||Covidien Lp||Tissue stop for surgical instrument|
|US9295522||Nov 8, 2013||Mar 29, 2016||Covidien Lp||Medical device adapter with wrist mechanism|
|US9301691||Oct 17, 2014||Apr 5, 2016||Covidien Lp||Instrument for optically detecting tissue attributes|
|US9301753||Mar 28, 2012||Apr 5, 2016||Ethicon Endo-Surgery, Llc||Expandable tissue thickness compensator|
|US9301759||Feb 9, 2012||Apr 5, 2016||Ethicon Endo-Surgery, Llc||Robotically-controlled surgical instrument with selectively articulatable end effector|
|US9307965||Jun 25, 2012||Apr 12, 2016||Ethicon Endo-Surgery, Llc||Tissue stapler having a thickness compensator incorporating an anti-microbial agent|
|US9307986||Mar 1, 2013||Apr 12, 2016||Ethicon Endo-Surgery, Llc||Surgical instrument soft stop|
|US9307987||Sep 25, 2014||Apr 12, 2016||Ethicon Endo-Surgery, Llc||Surgical cutting instrument that analyzes tissue thickness|
|US9307988||Oct 28, 2013||Apr 12, 2016||Ethicon Endo-Surgery, Llc||Staple cartridges for forming staples having differing formed staple heights|
|US9307989||Jun 26, 2012||Apr 12, 2016||Ethicon Endo-Surgery, Llc||Tissue stapler having a thickness compensator incorportating a hydrophobic agent|
|US9314246||Jun 25, 2012||Apr 19, 2016||Ethicon Endo-Surgery, Llc||Tissue stapler having a thickness compensator incorporating an anti-inflammatory agent|
|US9314247||Jun 26, 2012||Apr 19, 2016||Ethicon Endo-Surgery, Llc||Tissue stapler having a thickness compensator incorporating a hydrophilic agent|
|US9320518||Jun 25, 2012||Apr 26, 2016||Ethicon Endo-Surgery, Llc||Tissue stapler having a thickness compensator incorporating an oxygen generating agent|
|US9320520||Aug 19, 2015||Apr 26, 2016||Ethicon Endo-Surgery, Inc.||Surgical instrument system|
|US20130221066 *||Mar 28, 2013||Aug 29, 2013||Covidien Lp||Grasping jaw mechanism|
|EP2687163A1||Jul 17, 2013||Jan 22, 2014||Covidien LP||Multi-fire surgical stapling apparatus including safety lockout and visual indicator|
|EP2777523A1||Mar 11, 2014||Sep 17, 2014||Covidien LP||Interchangeable tips for surgical device|
|U.S. Classification||227/175.1, 227/19|
|Cooperative Classification||A61B17/07207, A61B2017/2919, A61B2017/2927, A61B2017/2929, A61B2017/00367, A61B17/0682|
|Feb 26, 2009||AS||Assignment|
Owner name: TYCO HEALTHCARE GROUP LP, CONNECTICUT
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:SCIRICA, PAUL;BEARDSLEY, JOHN W.;REEL/FRAME:022313/0727;SIGNING DATES FROM 20090218 TO 20090225
|Oct 2, 2012||AS||Assignment|
Owner name: COVIDIEN LP, MASSACHUSETTS
Free format text: CHANGE OF NAME;ASSIGNOR:TYCO HEALTHCARE GROUP LP;REEL/FRAME:029065/0448
Effective date: 20120928
|Dec 8, 2014||FPAY||Fee payment|
Year of fee payment: 4